title: Tracking progression of patient state of health in critical care using inferred shared dynamics in physiological time series.
abstract: Physiologic systems generate complex dynamics in their output signals that reflect the changing state of the underlying control systems. In this work, we used a switching vector autoregressive (switching VAR) framework to systematically learn and identify a collection of vital sign dynamics, which can possibly be recurrent within the same patient and shared across the entire cohort. We show that these dynamical behaviors can be used to characterize and elucidate the progression of patients' states of health over time. Using the mean arterial blood pressure time series of 337 ICU patients during the first 24 hours of their ICU stays, we demonstrated that the learned dynamics from as early as the first 8 hours of patients' ICU stays can achieve similar hospital mortality prediction performance as the well-known SAPS-I acuity scores, suggesting that the discovered latent dynamics structure may yield more timely insights into the progression of a patient's state of health than the traditional snapshot-based acuity scores.
authors.forename: Li-wei H
authors.initials: LW
authors.lastname: Lehman
authors.forename: Shamim
authors.initials: S
authors.lastname: Nemati
authors.forename: Ryan P
authors.initials: RP
authors.lastname: Adams
authors.forename: George
authors.initials: G
authors.lastname: Moody
authors.forename: Atul
authors.initials: A
authors.lastname: Malhotra
authors.forename: Roger G
authors.initials: RG
authors.lastname: Mark
mesh_terms: D000328:Adult; D019540:Area Under Curve; D062186:Arterial Pressure; D003422:Critical Care / Q000379:methods*; D018450:Disease Progression; D017052:Hospital Mortality; D006801:Humans; D008991:Monitoring, Physiologic; D012044:Regression Analysis; D012815:Signal Processing, Computer-Assisted